SSM REGIONAL HEALTH SERVICES (NPI# 1912965328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912965328 |
| Entity Type | Organization |
| Organization Name | SSM REGIONAL HEALTH SERVICES |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
2016 S Main Street Maryville MO 64468-2655 |
| Mailing Address |
1145 Corporate Lake Dr Saint Louis MO 63132-2907 |
| Practice Telephone | 6605622525 |
| Practice Fax Number | 6605624303 |
| Mailing Telephone | 3149892684 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | MICHAEL BAUMGARTNER (PRESIDENT) |
| Authorized Official Telephone | 6605622600 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM REGIONAL HEALTH SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 268540-RURAL HEA | MO | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0565614 | 05 | |
| MO | 595973009 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| 1679961577 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109-9508 | 2014-12-30 |
| 1306280185 | Ssm Regional Health Services | Clinic/Center | 301 E Price Ave, Suite A, Savannah, MO 64485-2427 | 2013-04-23 |
| 1396886065 | Ssm Regional Health Services | Family Medicine | 2511 W Edgewood Dr Ste G, Jefferson City, MO 65109-5869 | 2007-02-08 |
| 1427063072 | Ssm Regional Health Services | Pharmacy | 875 Hwy 5 South, Tipton, MO 65081-8253 | 2006-07-30 |
| 1518909373 | Ssm Regional Health Services | Family Medicine | 24 West 4th Street, Grant City, MO 64456-0043 | 2006-06-13 |
| 1396782587 | Ssm Regional Health Services | Clinic/Center | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-05-31 |
| 1588601777 | Ssm Regional Health Services | Clinic/Center | 875 State Route 5, Tipton, MO 65081-8441 | 2006-05-31 |
| 1053368159 | Ssm Regional Health Services | Clinic/Center | 2701 West Edgewood, Suite 101, Jefferson City, MO 65109 | 2006-05-27 |
| 1952357352 | Ssm Regional Health Services | Clinic/Center | 140 Northstar Dr, Holts Summit, MO 65043-1123 | 2006-05-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | SSM REGIONAL HEALTH SERVICES | 10101 Woodfield Lane, St. Louis, MO 63132 |
| Street Address |
2016 S MAIN STREET |
| City | MARYVILLE |
| State | MO |
| Zip Code | 64468-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619315603 | William Sean Prescott | Counselor | 318 North Main, Maryville, MO 64468 | 2013-06-12 |
| 1215284617 | Janet Luzmoor | Counselor | 109 East Summit Dr, Maryville, MO 64468 | 2012-08-06 |
| 1629336177 | Kristi Renee White | Social Worker | 423 N Market St, Maryville, MO 64468 | 2012-05-02 |
| 1285942474 | Kyle William Bowers | Physical Therapist | 2016 South Main Street, Maryville, MO 64468 | 2010-09-22 |
| 1861600660 | Debra Anne Hopkins | Physical Therapist | 2416 South Main St, Maryville, MO 64468 | 2007-05-18 |
| 1023235975 | Susan Kay Grispino | Occupational Therapist | Area Cooperative for Educational Support, 1429 South Munn Avenue, Maryville, MO 64468 | 2007-04-20 |
| 1760542567 | North West Missouri State University | Clinic/Center | 800 University Drive, Maryville, MO 64468 | 2006-12-11 |
| 1528154994 | Bruce E Twaddle | Dentist | 231 Summit Drive, Maryville, MO 64468 | 2006-10-05 |
| 1669588075 | Stanley David Snyder | Dentist | 2825 South Main Street, Maryville, MO 64468 | 2006-08-21 |
| 1710906896 | Ileen Richey-arellin | Social Worker | 109 E Summit Drive, Family Guidance Center, Maryville, MO 64468 | 2006-07-19 |
| Find all providers in zip 64468 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821562265 | Mosaic Medical Center - Maryville | Clinic/Center | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SSM REGIONAL HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.